| NPI | 1316960164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 3200) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WY 236) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2015-08-24 |